Investor’s Business Daily, BRAIN TRUST, March 7, 2003

When Massachusetts senator and Democratic presidential hopeful John Kerry found out that he had prostate cancer, he went to the best prostate surgeon in the world, Dr. Patrick Walsh of Johns Hopkins University Hospital, to have the gland removed. Following the successful procedure earlier this month, Walsh remarked that Kerry was “out of the woods.”

That Mr. Kerry sought out the most accomplished and skilled surgeon in the land is perfectly understandable. The irony, however, is that Mr. Kerry supports the creation of a single-payer health-care system that would not afford beneficiaries the same access to quality care that the senator himself enjoys.

Only Answer
It has been nearly 10 years since the Clinton health-care plan, which would have put control of health care into the hands of government, was laid to rest. And yet, the idea of universal coverage is once again “out of the woods,” with Mr. Kerry, among others, leading the charge. Proponents believe that universal coverage is the only viable solution to the problems facing the health-care industry in the U.S.

A popular rallying cry for supporters of universal coverage has been Canada’s single-payer health-care system. Congressmen Jim McDermott and John Conyers have introduced legislation modeled on the Canadian system, as has California state senator Sheila Kuehl. But Canada only offers a false promise for what ails the U.S.

As a former Canadian now living in the U.S., I have witnessed firsthand the failures of national health care. Implemented in 1971, the Canadian system provides excellent evidence of what happens to the quality of care when government is the sole provider – long waiting lines for critical procedures, lack of access to current technology, increasing costs to taxpayers and patients, and a brain drain of doctors, who head south for better working conditions and more money.

Waiting Longer
Kerry is the beneficiary of this brain drain. Yet, under a Canadian-style system, which claims to deliver comprehensive, accessible, and universal care, he would likely have to wait months for critical care.

According to the Fraser Institute’s 12th annual survey, Waiting Your Turn: Hospital Waiting Lists, total average waiting time for patients rose to 16.5 weeks in 2001–02, 77 percent higher compared to 1993. In Canada’s most populous province, Ontario, the average wait time in 2001–02 for prostate cancer treatment after seeing a specialist rose to 8.5 weeks from 6.5 weeks in 2000–01. Senator Kerry, who underwent a biopsy in December, a precautionary bone and CAT scan in January, and surgery in February, was not forced to wait for treatment. No one else should have to wait either.

But it’s not simply a question of waiting. In Canada, the federal government sets and administers the national standards for provincial health care. It transfers federal funds to provincial governments, where physicians are paid fee-for-service at government set rates. Because the rates are low, physicians perform more services, placing upward pressure on spending, and leading many provincial governments to cap the total amount they can bill in a year.

It doesn’t require a business degree to see that there are cost containment problems in a system where consumers pay nothing at the point of consumption and producers are left free to decide what to sell. The government is forced to control spending and hospitals are left shortchanged.

The end result is a severe under investment in high-tech hospital equipment (including radiology equipment), and ultimately, a rationing of care. Canadians confront few barriers—and no bills—when they need to see a primary care doctor. But should that doctor diagnose a serious disease, such as prostate cancer, Canadians, both young and old, are quickly exposed to their system’s limits.

Canadians have shown signs that they no longer tolerate such a system. In response to increasing outrage over health care quality and access, Prime Minister Chretien, in April 2001, established a commission to investigate the system and come up with some viable cures.

Need More Dollars
After 18 months of investigation, and $15 million in costs, the commission report has concluded, to no one’s surprise, that there is nothing wrong with the troubled system that more money, more regulations, and fewer private alternatives won’t cure. Admirers of Canada’s troubled system, like Senator Kerry, seem to think that the same logic applies on this side of the border. But that’s a prescription for disaster.

In his State of the Union speech, President Bush rightly argued that current problems “will not be solved with a nationalized health-care system that dictates coverage and rations care.” Medicare reform, medical savings accounts, and consumer-driven care will make for better health care in America, not a government-run single-payer system that promotes higher taxes, limits technology, produces long waiting lists, and prolongs suffering.

The market doesn’t have to work perfectly to work better than government. The next time a senator needs critical care, and seeks out the best doctor in the profession for timely and expert treatment, he should remind himself of this fact.

Sally Pipes is the President and CEO of the Pacific Research Institute, a California-based think tank. She can be reached via email at spipes@pacificresearch.org.